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DS4102 > W4 - Maxillofacial Injuries - Thomson > Flashcards

W4 - Maxillofacial Injuries - Thomson Flashcards

1
Q

What is carried out in the initial assessment of maxfax injuries (6)

A
  1. Rapid survey of vital functions & priotize managment options
  2. ABCDE
  3. Any head injury?
  4. Prevent infection
  5. Pain management
  6. Temporary immobilisation / fixation
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2
Q

What is the first thing to consider when managing head injuries

A

Prevention of secondary brain injury due to lack of cerebral circulation

ABC

Airway

Breathing (may have had chest injuries)

Circulation (control any haemorrhage)

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3
Q

What is required for proper diagnosis of maxfax injuries (5)

A

History

Exam

Diagnostic Features

Imaging

Study models

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4
Q

what are some facial soft tissue structures that can be affected by maxillofacial injuries (4)

A

Innervations (facial nerve / infraorbital nerve)

Parotid duct

Parotid gland

Nasolacrimal duct

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5
Q

How to manage hard tissue injuries / bone injuries (maxfax) (4)

A

Reduction (reduce the fracture zone aka put bone together)

Fixation

Immobilization

Rehabilitation

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6
Q

What to do with nasal fractures (immediately)

A

Push nasal bones back to original position straight away

  • Put thumb up nose and shift nose back to original position
  • Put splint afterwards
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7
Q

What indirect fracture can occur with injury to symphysis or parasymphysis (front of mandible or body)

A

Fractured condyle or angle

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8
Q

Where are the fractures

A

Direct fracture: Right parasyntheal fracture

Indirect fracture: Left angle of md fracture

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9
Q

Diagnostic features of fractured unilateral condyle (affected side 5 and opposite side 2)

A

Affected side

  • Joint pain (worse with moving)
  • Swelling & tenderness
  • Deviation of md on opening
  • Premature posterior contact
  • Abnormal movements of condylar head

Opposite side

  • Open bite
  • Limited lateral excursion
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10
Q
A

Unilateral condyle fracture

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11
Q

Diagnostic features of bilateral condyle fracture (5)

A

AKA “Guardsman fracture”

  • Pain, tenderness, swelling over both joints
  • Premature posterior contact
  • Anterior open bite
  • Restricted lateral movement
  • Absence of condylar head movement
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12
Q

Diagnostic features of body of mandible fracture (5)

A

Haematoma in floor of mouth / buccal sulcus

Trismus

Pain when moving jaw

Step deformity at lower border

Mental anesthesia

Derangement of occlusion

Movement & crepitus at fracture site

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13
Q
A

Body of mandible fracture

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14
Q
A

Bilateral condylar fracture

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15
Q

Diagnostic features of zygoma fractures

A

Depression of cheek prominence

Subconjunctival haemorrhage

Step deformity on infra-orbital ridge

Infra-orbital nerve anesthesia

Trismus

Blood in antrum

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16
Q
A

Zygoma fracture

  • notive step deformity of infraorbital ridge
  • Subconjunctival haemorrhage
  • Depression of cheek prominence
17
Q
A

zygomatic fracture

18
Q
A

Zygomatic fracture

19
Q

What is this and how is it caused

A

Retrobulbar haemorrhage (listen again 40 min)

20
Q

Describe the 3 le forts

A
21
Q

Features of le fort 1 fracture (4)

A
  • Floating palate
  • Blood in antrum
  • Bilateral haematoma
  • Deranged occlusion with anterior open bite
22
Q

Features of le fort 2 frac (5)

A

Gross swelling then dish faced deformity

Subconjunctival haemorrage

Bilateral infra-orbital nerve anesthesia

bilateral haematoma intra-orally

Retroposed upper dental arch w/anterior open bite

23
Q

Features of le fort 3 fracture

A

Gross swelling, then dish-faced deformity

Subconjunctival haemorrhage

CSF leak from nose

Head injury

Retroposed upper dental arch w / anterior open bite

24
Q
A

Isolated orbital floor fracture

25
Q

Complications of maxillofacial injuries (6)

A

Psychological trauma

Scarring

Soft tissue / bone loss

infection

Malunion

Trismus

DS4102 (37 decks)

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